Enterocyte Damage in Critically III Patients Is Associated With Shock Condition and 28-Day Mortality
Enterocyte Damage in Critically III Patients Is Associated With Shock Condition and 28-Day Mortality
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DOI：
10.1097/ccm.0b013e31828c26b5
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发表时间：
2013-09-01
影响因子：
8.8
通讯作者：
Capellier, Gilles
中科院分区：
文献类型：
--
作者：
Piton, Gael;Belon, Francois;Capellier, Gilles
目的：危重患者小肠功能障碍很常见，诊断不足，且与预后不良相关。肠脂肪酸结合蛋白是肠上皮细胞损伤的标志物，血浆瓜氨酸浓度是功能性肠上皮细胞质量的标志物。主要目的是确定与危重患者肠道脂肪酸结合蛋白相关的因素。次要目标是研究与血浆瓜氨酸浓度相关的因素及其与肠道脂肪酸结合蛋白的相关性。设计：前瞻性观察研究。设置：大学医院的 ICU 患者：18 岁或以上、预计 ICU 停留时间为 48 小时或更长时间的危重患者，无妊娠、慢性小肠疾病或慢性肾功能衰竭。干预措施：无。测量和主要结果：血浆肠脂肪酸结合蛋白和瓜氨酸浓度，以及与预后和治疗相关的变量在入住 ICU 时进行测量。其中包括一百零三名患者。入住 ICU 时肠道脂肪酸结合蛋白升高与儿茶酚胺支持、较高的乳酸浓度、较高的序贯器官衰竭评估评分和较高的国际标准化比率相关（所有 p
Objectives: Small bowel dysfunction in critically ill patients is frequent, underdiagnosed, and associated with poor prognosis. Intestinal fatty acid-binding protein is a marker of enterocyte damage, and plasma citrulline concentration is a marker of functional enterocyte mass. Primary objective was to identify factors associated with intestinal fatty acid-binding protein in critically ill patients. Secondary objectives were to study factors associated with plasma citrulline concentration and its correlation with intestinal fatty acid-binding protein.Design: Prospective observational study.Setting: ICU in a University HospitalPatients: Critically ill patients 18 years old or older with an expected length of ICU stay 48 hours or more, without pregnancy, chronic small bowel disease, or chronic renal failure.Interventions: None.Measurements and Main Results: Plasma intestinal fatty acid-binding protein and citrulline concentrations, and variables relating to prognosis and treatment, were measured at admission to the ICU. One hundred and three patients were included. Intestinal fatty acid-binding protein elevation at admission to the ICU was associated with catecholamine support, higher lactate concentration, higher Sequential Organ Failure Assessment score, and higher international normalized ratio (all p